This chapter discusses an example of how to chart such an inquiry, specifically, how to examine the historical and institutional processes that shape a health system and affect state response to a health-related issue. It explains reasons for deficiencies in state-provided urban primary care by conceptualising the link between urban space and population health and based on this conception, analysing the policy debates and conflicts that mark the origins of the National Health Service apparatus and its scope in cities. It also includes estimating the possibility for local collective action to forge its change. The variance in states’ responses to health issues thus derives in part from the distinctiveness of their health systems and health politics. Studying the politics of state-provided urban primary care therefore entails examining imaginaries of the urban as reflected in the state’s mandate for health and urban development and in local social contestations.